The AgileLife Patient Transfer System (PTS) developed and commercially deployed by Next Health LLC is an innovative new device that offers a zero-lift solution for patients who are unable to independently transfer to and from bed The AgileLife PTS consists of a fully powered hospital bed, a docking station, transfer system and a manual wheelchair. The device is operated by depressing buttons on a user-friendly handheld device. The system is designed to allow the patient to be simply, gently and easily transferred with little manual intervention required. The transfer process is achieved through an automated process of angular repositioning of the bed to align the body with the wheelchair which has a removable backrest and a seat that translates and rotates to receive a person. Conversely, a person is able to transfer from the wheelchair into the bed. The timing and angle of chair movement is adjustable through software that accommodates the transfer set up to the height, weight and other physical attributes of individual patients. The chair also converts to a commode thus avoiding the need for additional bathroom transfers. The AgileLife PTS has been evaluated informally in a variety of settings including with patients who have been able to return home under the Money Follows the Person Medicaid demonstration grant and with patients at the Hospital for Special Surgery in New York City, and Ability Beyond, a group of independent living homes in Connecticut and New York. Through informal discussions with the caregivers and healthcare professionals involved we became aware that while the system provided great benefit to some individuals, the wheelchair design limited others who could greatly benefit from the device. The goal of this project is to expand the product to accommodate bariatric individuals (e.g. persons that weigh over 250 lbs and up to 400 lbs) and add a tilt feature on both the standard (weight capacity under 250 lbs) and bariatric wheelchair models to accommodate individuals with postural repositioning needs. The new designs will be iteratively developed in collaboration with the University of Pittsburgh. Eight commercial ready systems will be built that meet the user, technical and manufacturing requirements established by expert panel review, wheelchair standards testing, and in-lab evaluations. Eight subjects will be recruited for a field trial with the PTS. The bed component of the AgileLife PTS will be installed in their home and 6 weeks baseline daily transfer and bed activity (e.g. occupied/unoccupied bed time) will be collected via a data-logging system built into the bed. The subjects will be fitted to the PTS wheelchair and the full PTS will be enabled. Survey- based data and daily transfer activity and bed activity will be collected and monitored for 6 weeks and compared to baseline activity. Successful outcomes of this project could result in a technology that enables nursing home eligible patients to remain at home and that lowers the risk of falls and injury to both patients and caregivers.